Pharmaceutical care of Arrhythmias

Question 1

How can first degree heart block be seen on a ECG?

Answer 1

Long pools before next PQRS

Question 2

*Not all P waves result in a QRS complex
*Atrial contraction is not always followed by ventricular contraction
*May follow a pattern, 2:1 ratio where alternate P waves are not conducted
*There are 2 P’s before QRS waves!
What is this?

Answer 2

Second degree heart block

Question 3

When there is no conduction through the AV node
-Atrial contraction continues due to the SA node
-Ventricular contraction is due to automatic rhythm of AV note but is much slower
-QRS wave doesn’t always happen,
What is this?

Answer 3

Third degree heart block - complete heart block
=Medical emergency!!

Question 4

What are the side effects of Amiodarone?

Answer 4

Rhythm Control
-Bradycardia
-Phototoxicity
-Slate-grey skin
-Taste disturbances
-Corneal microdeposits
-Liver dysfunction
-Thyroid dysfunction
-Pulmonary toxicity

Question 5

How often should bloods be done on someone on amiodarone?

Answer 5

Baseline
Then 3 monthly

Question 6

What are the side effects of Digoxin?

Answer 6

Rate control
-N&V
-Blurred vision
-Anorexia
-Bradycardia

Question 7

What drug would you often see antiemetics prescribed?

Answer 7

Digoxin

Question 8

What does Amiodarone do to levels of digoxin?

Answer 8

Increases levels of digoxin

Question 9

What should you do to the doe of digoxin if used with amiodarone?

Answer 9

Reduce digoxin dose by 50%

Question 10

Once a patients ventricular rate is reduced, what should be stopped with patients who have arrhythmia’s?

Answer 10

Stop digoxin